Tag Archives: reducing scars

Reduced Scalp Scarring from Hair Transplant Surgery

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FUE hair restoration can reduce scars

Modern hair transplant is resolving hair loss issues for many people. However the most common form of Follicular Unit Transplant (FUT) surgery ‘Strip Method’ procedure leaves a linear scar that is just not acceptable. This lends to the increasing popularity of Follicular Unit Extraction (FUE) hair restoration surgeries.

Healing of FUE Scars

FUE varies from the other FUT procedure by the method of extracting, or “harvesting,” donor hair. An FUE procedure involves the use of an instrument is to make a small, circular incision in the skin around a follicular unit, separating it from the surrounding tissue. The unit is then extracted (pulled) directly from the scalp, leaving a small wound.

This process is repeated until the hair transplant surgeon has harvested enough follicular units for the planned hair restoration. This nature of this process means it takes o time to complete the procedure. This of course varies under the number of grafts being extracted. The donor wounds are approximately 1-mm in size and in most cases heal within a week to ten days.
Patients can be concerned about the punctuate scars from FUE but in most cases they become undetectable in a short period of time.

Scars from FUE vary do to:
1. The size of the punch (ranges of punch sizes are from 0.8-1.5mm)
2. The density of the donor hair area; the thicker the hair the less visible the scars
3. The inverse is true; the thinner the donor hair the more visible the scare
4. The individual patients healing

Hypopigmentation

Generally, the donor area appears to heal without visible scarring. In some instances a patient can experience loss of color in the donor extraction wounds. These tiny spaces that lack the same degree of scalp colorization than the surrounding donor area. This is more apparent if the patient has darker skin. A hair transplant surgeon can test with a few test extractions prior to committing to a full surgery.

Minimizing Scars in Hair Transplant Surgery

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The modernization of hair restoration has made it an option for many men. The scarring from follicular unit transplantation which is a natural permanent solution to hair loss is a concern for many patients.
Fortunately a number of techniques have been developed to minimize donor scarring when using a strip excision during this surgery, as well as, post surgical solutions that can be done even years later.
Linear Follicular Unit Transplantation Scar
Surgical Solutions

Solutions that a surgeon can utilize during the procedure include:
• the use of tumescent anesthesia
• undermining
• absorbable sutures
• buried sutures
• staples, and
• trichophytic closures.

These advances in minimizing scarring makes FUT one of the best hair transplant treatments for men.
Scar minimization from the donor incision is an important component of a successful hair transplant procedure. A fine donor scar gives the patient more flexibility in hair styles post surgery. When the scar is fine the close cut military type hairstyles chosen by men and women can still be worn after hair restoration.

Four aspects to having the donor incision heal in a fine line:

1. placing the incision in the proper location
2. using the correct donor strip dimensions
3. removing the strip without damage to the tissue
4. closing the donor area with impeccable surgical techniques

Positioning the Donor Incision

The ideal placement of the donor incision is in the mid-part of the permanent zone located in the back and sides of the scalp. This area lies in a band that starts above the occipital protuberance (the bump felt in the middle part of the back of the scalp) and extends to either side in a gentle, upward sloping curve that follows the contour of the scalp. If hair is harvested below this region, there is a greater risk of scarring from the wound stretching, since the incision will be too close to the muscles of the neck. If the incision is above this area, the hair may not be permanent and may fall out as the baldness progresses.

Size of the Donor Strip

The length of the donor incision is determined predominantly by the number of follicular unit grafts required for the hair restoration, the width (height) of the donor incision depends upon the patient’s scalp laxity. This is a genetic attribute of the patient’s scalp that must be carefully measured by the hair transplant surgeon during the initial evaluation. With good scalp laxity, a wider strip may be harvested from the donor area without the risk of scarring (although patients with very loose scalps may be at increased risk of a wide scar If the scalp is too tight, taking a normal size strip may be impossible.

If the strip width is too narrow, the incision will need to be unnecessarily long to obtain an adequate amount of donor hair. If the strip width is too wide, the risk of having a widened scar will be increased significantly. Expert clinical judgment, acquired over years of experience, is needed for the surgeon to consistently set the appropriate length and width of the donor strip and achieve the minimum possible scar.

Pressure Treatment in Scar Healing

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compression garment for torso When an imbalance occurs between the anabolic and catabolic phases of the healing process in a wound somtimes more collagen is produced than the is degradation of collagen in the healing process. This results in the scar growing in all directions. The scar is elevated above the skin and remains hyperemic. This is excessive scar tissue is medically classified either as a keloid or a hypertrophic scar.

There are several nonsurgical options that are utilized to treat of these abnormal type scars. Pressure is a treatment that has demonstrated a level of success in some patients. The use of pressure to treat scars is thought to decrease tissue metabolism and increase collagen breakdown within the wound. Pressue is sometimes used preventatively in patients who have a history of keloid or hypertrophic scarring.

There are various different methods for administering pressure to facilitate this type of treatment including:
• elastic bandages (eg, Ace wraps) for the extremities
• thromboembolic stockings for the feet
• Isotoner-type gloves for the hands.
• custom-fitted compression garments can be used for the more difficult areas ( lower neck and torso).

ACE wraps or stockings are not useful for areas such as the head and face this is primarily because of discomfort and patient compliance Is not likely. Optimal results with latex-free compression garments are achieved usually in 6 -12 months during the maturation of the wound.

Understanding Burn Scars

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Man's severe burn scar revised

Quality of Life and Scarring
Scars are an inevitable part of most peoples’ lives. There is nearly a person on earth who does not have some type of scarring. Severe scarring though affects individual’s quality of life and often decreases their self image. Self image is so much a part of person’s happiness and success that medical science has gone a long way to reduce the adverse effects of scarring no matter how the scar occurred.

Uniqueness of Burn Scars
Burn scars are often very traumatic, disfiguring and they are the hardest to treat through revision. When a person has significant scarring from burns there is often associated trauma that takes priority prior to addressing the issue of scarring. Life saving measures, infections and other complications take persistent over issues that will arise from burn scars.

Pain management is very vital because the pain from burn is one of the most excruciating types of pain one can bear. Where healthy skin and burned skin intersect pain can be a life time issue. Psychological issues such as severe depression are a compounding factor for people disfigured from burns. Scar tissue does not maintain the suppleness or laxity of healthy skin. As scars mature the fibrotic tissue composing it shrink and becomes more rigid. The location of such scars near joints of the hands, feet, limbs and neck can adversely affect the mobility of the joints.

Another issue with burn scarring is the need for skin grafting and the associated healing and scarring with those procedures. In addition burn scars because of the severity often are comprised of a combination of types of scars. This includes:

• Hypertrophic scarring
• Hypotrophic scarring
• Hyper-pigmentation scarring
• Keloid scarring

The Treatment
Traumatic burn scars necessarily are to be treated in absolute sterile clinical conditions, usually in specialty “burn centers”. Pain management is one of the important reasons as well as reducing the risk of infection to a minimum. Topical numbing creams do not penetrate burn scar tissue sufficiently and medical needling must be done under general anesthetic in most cases. Treatment for burns is a long process that can easily reach up to one year and intervals of specialized care are scheduled through a close monitoring process. It is during these interval medical treatments that the patient and doctor can discuss the possibility or revisioning scars.

Scar Revision Insurance Coverage

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The unpredictability of scars is a part of the human experience. Many scars are unobtrusive and we often forget about them. It is not uncommon especially among machismo male culture to embellish the history of a scar as a rite of passage. Unfortunately for many people a scar can be a debilitating phenomenon emotionally and physically. It is for these reasons that some insurance programs will cover scar revision for patients.

The formation of a scar depends as much upon the way your body heals. Likewise your individual healing process combined with the surgeon’s skill affects the success of a scar revision surgery outcome.

The factors that affect scarring are:
• the size and severity of the wound,
• its shape and direction
• the original color and thickness of your skin
• the blood supply to the injured area.

The merits as to the need for plastic surgery are a highly personal decision, and are different for each person.

Types of Scars
• Stretch Mark Removal
• Keloid scars
• Hypertrophic scars
• Contractures

Common Scar Revision Surgeries
• Z-plasty
• Flap surgery
• Skin grafting

Medical Insurance May Cover Cost of Scar Revision

Scar revision cost may include:
• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Prescriptions for medication
• Post-surgery garments
• Medical tests

Though many health insurance plans will not cover scar revision surgery for cosmetics alone. If the surgery if for complications related to the injury and the scar can be revised through the procedure it can be covered. Some policies also include coverage for scarring that is limiting body functionality. You must carefully review your health insurance policy.

It is impossible to remove a scar completely. However, plastic surgery can often do much to lessen the severity of a scar, making it less noticeable by applying or injecting steroids or through scar revision, a commonly used surgical procedure. Many people assume that as elective surgery it has to be an out of pocket expense. This is not necessarily true. Check with your medical insurance provider to see if this is the case; don’t assume. Many people improve their self image and quality of life through scar revision surgery.

Scar Revision from Breast Augmentation

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All surgeries are going to leave a scar. The leading cosmetic surgeons who specialize in breast augmentation are good at reducing the visibility of the scar. The very best surgeons make sure only very close scrutiny reveal the signature of their work. The techniques for revising scars very and are applied as the surgeon deems best for the patient and their particular case. Often women undergo more than one breast implant surgery. If a woman has suffered from a poor elective procedure the top cosmetic doctors can redo the surgery and also revise the scarring in the same procedure.

Do breast implants last a lifetime? Women considering breast augmentation ask this question frequently. Breast implants are not made with an expiration date, so you should be able to enjoy the results for many years. However, unexpected issues occur for a certain number of patients. If you think you’re experiencing a problem with your breast implants, call us to schedule a consultation and Dr. Hess will see you as soon as possible.

Reasons for Revision Breast Augmentation
Problems that occur after breast implant surgery. Most often they are corrected with a brief revision surgery. Of course, Some of the reasons women seek revision of breast augmentation are :

  • Breast implant rippling
  • Volume adjustment of saline implants
  • Scar revision procedure
  • Change in implant size preferences
  • Switch from saline to silicone implants
  • Areola size reduction
  • Noticeable breast asymmetry
  • Symmastia
  • Nipple ptosis or sagging
  • Breast implant displacement
  • Breast implant rupture
  • Nipple malposition
  • Scar tissue surrounding implant
  • High riding implants

    • Evolution of Scars – Part 2

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    Why Do We Have Scars?

    “Human wound healing appears to have been optimized for quick healing in dirty conditions,” Mark W. J. Ferguson, Ph.D., University of Manchester.

    Part II
    Before and After Facial Scar Revision of Young Woman
    Anthropologists and science have yet to explain why humans develop larger and thicker scars than other animals. Our response to scars reaches back through the eons of human evolution. A physically weaker structure than most mammals; humans live longer than any other mammal it perhaps is our species wound healing that allows us to thrive. When we’re injured; cut or burned, the immune system is immediately activated to close the wound and heal it.

    Surgeon N. Scott Adzick, M.D., researches and studies scarring at the Center for Fetal Diagnosis and Treatment at the Children’s Institute for Surgical Science in Philadelphia, he notes:

    “If you’re a caveman or cave-woman running around, and you get bitten by a saber-toothed tiger, it makes sense to patch that wound together as quickly as possible in order to survive, as opposed to devoting the body’s energy and resources to healing perfectly”

    The result is that our bodies’ rapid immune response to inflammation leads to the larger and thicker scabbing and scarring. Some social anthropologists theorize that scars served as sexual attractors. Heavily scarred early men would be more attractive because it indicated there bravery and strength in survival.

    No matter the theory or culture scars are part of human life; if you know someone who is experiencing anxiety from scars. Today’s cosmetic medicine may have the answers.

    Scars & Wound Healing

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    Scars are the evidence of injury and the preexistence of a wound. The wound can be minor or traumatic either way a malformation and marking of the skin can occur leaving a scar. Understanding wound healing is important if one wishes to reduce scarring.


    Scars

    Wound Healing

    Any trauma to the skin can create a wound can create a wound which leads to the potentiality of scarring. There are many physiological processes that effect wound healing. The process is a delicate one in which many various factors can affect the outcome. The outcome can be minimal to severe scarring. Wounds are made of collagen. Collagen is produced by the body to hold the wound together.

    3 Phases of Wound Healing

    1. The inflammatory phase, this phase begins upon injury, immediately when the wound is sustained and it lasts 2 to 6 days. During this period the injured area is usually warm and red. The wound is often swollen at this time and painful. The inflammatory phase is characterized by:
    a. The cessation of bleeding
    b. The proliferation of white blood cells to the wound area to fight bacterial infection
    c. The formation of collagen begins. In this phase, the wound is usually warm, red, swollen, and painful.

    2. The proliferative phase begins next and continues approximately 3 to 4 weeks. Collagen production increases rapidly drawing the borders of the wound together facilitating wound closure. The body also produces new capillaries to aid in healing. The proliferative phase is characterized by:
    a. The skin edges of the wound become visibly thicker.
    b. Granulation tissue is formed this is often represented by new red, bumps in the shrinking wound
    c. Cells that help to keep the wound clean and fight infection can cause the wound to be wet, weeping, and white or yellow in appearance. (However if thicker white pus presents; it is a sign of an infection and should be treated.)

    3. The maturation phase follows the proliferative phase and continues for a period from several weeks to several years. This phase involves the formation of even more collagen to strengthen the wound, and the development of scar tissue. This is the body’s form of “remodeling” to lessen excess collagen in the scar. This can be observed by example of a thick, red, raised scar to a thin, flat, blended scar over a period of months to years.

    Reducing Scarring from Ingrown Hairs

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    How to get Rid of Ingrown Hair Scars

    Body hairs sometimes become ingrown and can often leave scars.

    Where hair grows which is anywhere in the body ingrown hair can occur, though they are more likely on places where you regularly remove hair. Men commonly experience ingrown hairs on the face, back, chest, legs and arms. Women tend to have ingrown hairs on the bikini area, legs and armpits. If you pick or squeeze ingrown hairs, you may damage the skin permanently. Scars from ingrown hairs are very common. Thankfully, there are many things you can do to reduce the appearance of ingrown hair scars.

    Medical Treatments

    Facial In Grown Hair ScarringVisit a dermatologist. A doctor can prescribe you stronger bleaching or fading creams. Ask your doctor about Retin-A creams. These topical treatments encourage cell regeneration, meaning that you’ll have a fresher, more even skin tone with regular use.

    Get laser treatment on the ingrown hair scars. Laser light will target the hyperpigmentation in the scars, thereby lightening the area. In addition, laser treatments encourage collagen production so your skin will look firmer and more even. Laser treatments can be quite expensive, and you’ll generally need multiple sessions to achieve satisfactory results.

    Talk to your dermatologist about chemical peels to lighten the ingrown hair scars. Depending on the severity of scars, you can opt for light, medium or deep chemical peels. Your skin will be burned by the chemicals, but after it heals, younger skin will be revealed. If you opt for a series of peels, you’ll generally have better results.

    Consider microdermabrasion on the scarred area. The top layers of your skin will be buffed away by a mini sandblaster-type device. The skin below will be younger and less damaged so the scars will not be as apparent.

    Personal Hygiene

    Exfoliate the area, by using a body scrub and loofah. Exfoliation removes dead skin cells, thereby encouraging new skin cell production. Less damaged skin cells will be apparent sooner when you exfoliate regularly.

    Wear sunscreen on the scarred area. The sun will often worsen the appearance of ingrown hair scars. In order to fade the scars more quickly, keep the area protected from the sun’s damaging rays. Choose a full-protection sunscreen with a high SPF rating.

    Some people report having results by rubbing cocoa butter on the ingrown hair scars. Cocoa butter has been shown to fade scars and encourage healthy skin.

    Ingrown hair scars usually have a darker pigmentation than the surrounding skin. When applying bleaching cream to the scars it will lighten the scars, helping then blend in with the rest of your skin. You’ll need to apply most over-the-counter bleaching creams twice a day for several weeks before you see results.